The other side of statins: They've saved countless lives - but now doctors
fear for some, the side effects could be devastating

Permanent nerve damage:
Smallholder Paul Rhoades is now largely dependent on a wheelchair after
taking statins

Smallholder Paul Rhoades was counting his sheep - as he did every day - when
he stopped, unable to focus or remember what he was doing. 'I couldn't remember
which sheep I'd counted and which I hadn't,' he recalls. 'Counting was beyond
me.'

Paul, who was then aged 57, was concerned. 'I had a flicker of panic that it
might be a sign of Alzheimer's - but I tried to put it to the back of my mind.'

But the problem did not disappear, and Paul became increasingly forgetful.

'I was constantly losing my thread in conversations and forgetting people's
names. I'd walk into the kitchen to feed my dogs and then struggle to remember
what I'd gone in there for. It was like a fog had descended on my brain.'

Paul, from Llanrwst, North Wales, also began suffering muscle pain and cramps
in his legs, and had problems with balance and co-ordination. 'I had a weird
feeling that my legs were out of sync with my brain,' says Paul. 'I also felt
very tired.'

A few months earlier, a routine check-up had revealed that Paul had high
cholesterol levels; at 9.7 these were well above the recommended limit of 5. So,
like six million other people in the UK with raised cholesterol, Paul was
prescribed a statin to reduce his risk of heart attack or stroke.

He was given the standard 40mg daily dose of simvastatin - the most commonly
prescribed statin in the UK.

Not long after, he developed his troubling symptoms - symptoms which have
since worsened, leaving Paul, now 64, largely dependent on a wheelchair. He is
convinced that statins are to blame.

Worryingly, his story is far from unique, with new evidence suggesting many
more people than previously thought suffer adverse reactions to the drugs.

Until recently, the acknowledged side effects included muscle pain and
damage, gastro-intestinal problems, headaches, joint pains and peripheral
neuropathy (nerve damage and loss of feeling in the hands and feet).

Then last November the drug safety watchdog, the Medicines and Healthcare
Products Regulatory Agency, issued warnings about five 'new' possible
side-effects: memory loss, depression, sleep disturbance, sexual dysfunction and
a rare lung disease.

These had, in fact, been highlighted by the MHRA nearly two years before,
after adverse reactions were reported through its yellow card scheme - where
health professionals and patients report any suspected side-effect associated
with a drug.

According to the MHRA, there were 3,505 reports of suspected adverse
reactions involving statins and cognitive function, memory loss and nerve damage
between 2005 and 2009.

However, GP Malcolm Kendrick, author of The Great Cholesterol Con, believes
the true number is much higher. 'A maximum of one per cent of adverse events are
actually reported. So this figure represents the tip of a very large iceberg.

Other evidence is emerging to suggest the rate of side-effects is much higher
than thought.

Previously, only one per cent of patients were said to suffer some type of
statin reaction, but a study at the University of California suggests the figure
for muscle pain - the most commonly reported reaction - was nearer 20 per cent.

Another study published in the Primary Care Cardiovascular Journal found
muscle damage was underdiagnosed.

Researchers analysed the patients' records at an 8,000-patient practice and
found just one recorded case. But after interviewing 92 patients, 19 new cases
were diagnosed.

54million

The number of adults in the UK with
high blood pressure, that's one in every two

As Dr David Sciberras, a GP in Gloucester and the lead researcher, explains:
'This study only looked at muscle pain side-effects, but the same principle
could apply to memory and cognitive problems, though these are much less
common.'

What triggers these side-effects? Muscle pain may occur because statins block
the production of co-enzyme Q-10, which is essential for energy production in
all muscles.

Nerve damage and memory problems may be linked to reduced cholesterol
production.

Cholesterol is essential to maintain the myelin sheath, which surrounds and
protects the nerve cells and is used in the brain to build synapses, which
create and store memory.

Most doctors argue that side effects are rare, and statins can help save the
lives of people who have had a heart attack.

The question is whether they should be given to people such as Paul, who
aren't otherwise ill but have high cholesterol; or indeed, as some experts are
now suggesting, to everyone over the age of 50.

For Paul Rhoades, the answer is an unequivocal 'no'.

Nine months after starting on statins, Paul went back to his GP. 'I joked
about my memory loss, but he didn't really pick up on it. He explained that
muscle pain was sometimes a side effect and changed my prescription.'

Paul was put on Lipitor, the second most frequently prescribed statin.

Although this reduced his cholesterol to 5.5, and his balance and
co-ordination problems improved, the muscle pain got slowly worse over the next
18 months, and his legs progressively weakened.

'I was having to walk with sticks and was struggling to walk my dogs. The
pain made me feel nauseous and drained my energy.'

Three years after starting on statins, the pain was so bad that Paul was
referred to a neurological hospital in Liverpool.

'I had three MRI scans on my back and leg, and made at least 12 visits to the
hospital in three years, but no one could offer any explanation.

'My right leg muscles began wasting away and left me with very little
movement. Then the same thing happened to my left leg. Eventually, I had to
resort to a wheelchair.'

Towards the end of 2008, his neurologist concluded the problems were due to
damage to the myelin sheaths in his legs, but couldn't find a cause.

Last August, Paul began searching the internet for clues. 'When I started
reading people's accounts about statins' side-effects, it all sounded so
familiar, particularly the memory problems and muscle pain. I stopped taking the
statins immediately.

'My memory and general mental fogginess began to improve, and within four
weeks I could notice a real difference. After a few more months, I was back to
my old self mentally. It was fantastic.'

Unfortunately, the nerves in his legs are irreparably damaged. 'I feel angr y
about wasting all those years on statins feeling so dreadful, and the fact that
I've been left with permanent nerve damage,' he says.

'It's very difficult to prove that my problems were caused by statins, but no
one has offered any other satisfactory explanation.'

Paul has now joined an internet support group, UK Sufferers of Statin
Side-Effects.

'Patients are constantly told the benefits of statins outweigh the
side-effects but I would dispute this,' says Dr Malcolm Kendrick.

'Even if a man who had a heart attack, and was at high risk of another, took
statins for 40 years, he would only extend his life by just 17.5 days. Is it
really worth putting up with all those side-effects for that?'

This view is highly controversial. Much more representative is Hastings GP Dr
Jonathan Morrell, a founder of the charity Heart UK and the Primary Care
Cardiovascular Society.

'Most clinical trials have shown patients on statins have at least a 30 per
cent reduced risk of suffering a cardiac event,' he says.

'One recent study in Israel has shown there are benefits in taking statins
even if you don't have heart disease, and revealed as much as a 45 per cent
difference in the death rate between those who took them and those who didn't.'

'Muscle pain is the side-effect we have to battle with and see most, but we
can help three out of five patients by reducing their dosage, switching brands,
or looking at possible drug interactions.'

'However, we must take notice of the rise in yellow card reports and the MHRA
is sensible to issue warnings. This ought to trigger further high- quality
scientific investigation.

'In the meantime, we must be careful not to exclude statins from those who
need them on the basis of ideas not yet proven.'